Background to this inspection
Updated
3 September 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by an inspector.
Service and service type
This service provides care and support to people living in three ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the registered manager would be available to support the inspection.
What we did before the inspection
We reviewed information that we held about the service such as notifications. These are events that happen in the service that the provider is required to tell us about. We also considered the last inspection report and action plan and looked at the Provider Information Return (PIR). This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with three people and observed staff as they supported people and spent time with them. We spoke with the registered manager, senior support worker and two other members of support staff. We reviewed a range of records. This included two people’s detailed care records, one of these in an easy read format, medicine administration records, records of accidents and incidents and audits and quality assurance reports. We looked at two staff files in relation to recruitment and staff supervision.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
After the inspection
We spoke with four relatives and health professionals.
Updated
3 September 2019
About the service: Choice South West is part of HFT a national provider of services for people with learning disabilities. This service provides personal care and support to people in their own homes in and around the Tiverton area. There are two main sites where people have their own tenancies and support is provided over a 24-hour period, and one person lived in their own home.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. The service currently supports 14 people receiving personal care.
People’s experience of using this service and what we found
People said they felt safe and cared for by the service. People were supported by staff who were compassionate, knew them well and with whom they had built trusting relationships. They were supported to express their views, and care was organised around their individual needs. Staff promoted people to be as independent as possible and upheld their right to privacy.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People's support focused on them having control over their daily lives and opportunities to take part in everyday routines.
People received effective care and consistent support from staff with the right skills to meet their needs. Staff monitored people’s health and wellbeing and worked with other professionals to make sure people received the treatment they required.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People received care and support in accordance with their wishes and preferences. Support plans gave information about people’s likes and dislikes and staff knew people well. People were actively engaged in meaningful activities and relationships.
People were protected from abuse by staff who were aware of the different types of abuse, and ways to protect people. People received their medicines safely and on time.
The service was well led by the registered manager. The culture was open and promoted person centred values. People, relatives and staff views were sought and taken into account in how the service was run. The provider had systems in place to monitor the quality of care provided and made improvements in response to their findings.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 22 February 2017). At this inspection the ratings for the service have remained the same.
Why we inspected
This was a scheduled/planned inspection based on date of registration
Follow up
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.